Managing superior vena cava syndrome as a complication of pacemaker implantation: a pooled analysis of clinical practice

Pacing and Clinical Electrophysiology : PACE
Robert F RileyYaver Bashir

Abstract

Superior vena cava syndrome (SVCS) is a rare complication of pacemaker implantation. Numerous methods have been employed to treat this condition, ranging from anticoagulation and thrombolysis to surgical interventions and stenting. However, thus far only small case series have been reported and there is no currently accepted standard of care. Our group preformed a PubMed literature search to identify cases of symptomatic SVCS that developed following implantation of permanent pacemakers or implanatable cardioverter defibrillators and were treated with one of five different modalities: anticoagulation, thrombolysis, venoplasty, stenting, and surgical reconstuction. Duration of follow-up and incidence of recurrence of symptoms were the main end-points. One hundred and four eligible cases from 74 different publications were identified, in which SVCS presented at a median of 48 (range 0-396) months after device implantation. We found that over the last 40 years, conservative treatments have been replaced by surgical reconstruction, and most recently by stenting, as the most common therapeutic modality employed. Anticoagulation, thrombolysis, and venoplasty alone were all associated with high recurrence rates. Surgery and stenting w...Continue Reading

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Related Concepts

Artificial Cardiac Pacemaker
Relapse
Superior Vena Cava Thrombosis
Stent, Device
Implantable Defibrillator
Prosthesis Implantation
Anticoagulation Therapy
Complication
Patient Care
Implantation Procedure

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